Healthcare Provider Details

I. General information

NPI: 1801347364
Provider Name (Legal Business Name): CELESTIAL SPRINGS COUNSELING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2016
Last Update Date: 10/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 UNSER BLVD SE SUITE C
RIO RANCHO NM
87124-6300
US

IV. Provider business mailing address

12 UNSER BLVD SE SUITE C
RIO RANCHO NM
87124-6300
US

V. Phone/Fax

Practice location:
  • Phone: 575-770-0372
  • Fax:
Mailing address:
  • Phone: 575-770-0372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH GERARD LUKAS-DROUILLARD
Title or Position: BOARD PRESIDENT/PSYCHOTHERAPIST
Credential: LCSW
Phone: 419-698-1482